The Chinatown Patient Navigation Program: Adaptation and Implementation of Breast and Cervical Cancer Patient Navigation in Chicago’s Chinatown

Abstract

Background Among Chinese-American women, cancer is the leading cause of death, with breast and cervical cancer among the most frequently diagnosed cancers. 1,2 A myriad of linguistic, cultural, access, and health care system barriers contribute to poor cancer outcomes among this population. 3,4 These forces are evident in the low utilization rates of preventive care and cancer screening in Chicago's Chinatown, one of the largest communities of lowincome, working-class Chinese immigrants. 5 As an example, according to population-based survey of Chinese older adults in Chicago's Chinatown, the percent of women reporting ever having a mammogram is 59% and reporting ever having a Papanicolaou (Pap) test is 41%. In 2012, as part of a longstanding community-based participatory research partnership, researchers and leaders from Northwestern University, the

Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature

“…The majority of included articles were quantitative studies (n = 36), 28 , 41 - 75 with a few qualitative (n = 16) 76 - 91 and mixed methods (n = 6). 92 - 97 Of the quantitative studies, 6 studies were randomized control trials.…”

“… 92 - 97 Of the quantitative studies, 6 studies were randomized control trials. 47 , 53 - 55 , 63 , 71 , 83 The United States (n = 50) 28 , 41 - 45 , 47 , 49 - 55 , 57 , 58 , 60 - 73 , 75 - 80 , 82 - 84 , 86 - 91 , 93 , 94 , 96 , 98 and Canada...…”

“…Most programs were implemented in community settings such as outpatient clinic settings or individuals’ homes (n = 29) 41 - 43 , 49 , 51 - 53 , 56 , 57 , 62 , 64 , 69 - 73 , 76 - 80 , 84 , 88 , 90 - 92 , 95 , 97 , 100 followed by hospitals (n = 26). 28 , 44 , 45 , 47 , 48 50 , 58 - 61 , 63 65 - 68 , 74 75 , 81 85 - 87 , 89 93 , 96 98 , 99 Although PNPs were initiated in 1 s...…”

“… 47 , 53 , 54 , 83 Of the studies that reported participant age, the mean ages were most often 55 to 65. 43 , 44 , 48 , 50 , 52 , 55 , 57 , 62 , 70 , 72 , 75 , 81 , 83 , 87 , 93 , 95 The eldest included patient was 93. 72 …”

“…Identifying care needs often occurred through formative research conducted by the program implementers and informed the design protocol. 50 , 65 , 73 , 87 Incorporating the implementation of a PNP into strategic plans of the organization demonstrated commitment. 43 System-level factors (ie, characteristics of healthcare systems) that also motivated organizations to implement a PNP included medical insurance and the need to improve coordinative care for patients when facing workforce shortages.…”